1. Field of the Invention
The present invention relates to vascular closure devices, and more particularly to vascular closure devices formed from bioabsorbable polymers and structures, blends of bioabsorbable polymers and plasticizers, blends of polymers, plasticizers, antibacterial agents and therapeutic agents, or any combination thereof. These polymeric closure devices may be prepared by different processes.
2. Discussion of the Related Art
Each year, patients undergo a vast number of surgical procedures in the United States. Current data shows about twenty-seven million procedures are performed per year. Post operative or surgical site infections (“SSIs”) occur in approximately two to three percent of all cases. This amounts to more than 675,000 SSIs each year.
The occurrence of SSIs is often associated with bacteria that can colonize on implantable medical devices used in surgery. During a surgical procedure, bacteria from the surrounding atmosphere may enter the surgical site and attach to the medical device. Specifically, bacteria can spread by using the implanted medical device as a pathway to surrounding tissue. Such bacterial colonization on the medical device may lead to infection and trauma to the patient. Accordingly, SSIs may significantly increase the cost of treatment to patients.
From a clinical perspective, it is generally necessary to administer a chemical compound that will provide anti-biotic or anti-bacterial, anti-fungal, or anti-parasitical activity when a vascular closure device is used in high-risk patients (e.g., prior MI, stroke, diabetes, or additional risk factors). Most infections associated with medical device are caused by bacteria. The primary mode of infection associated with medical device is attachment of microorganisms to the device followed by growth and formation of a biofilm on the device. Once a biofilm is formed, it is practically impossible to treat the infection without actually removing the device.
Implantable medical devices that contain antimicrobial agents applied to or incorporated within have been disclosed and/or exemplified in the art. Examples of such devices are disclosed in European Patent Application No. EP 0761243. Actual devices exemplified in the application include French Percuflex catheters. The catheters were dip-coated in a coating bath containing 2,4,4′-tricloro-2-hydroxydiphenyl ether [Ciba Geigy Irgasan; (DP300)] and other additives. The catheters were then sterilized with ethylene oxide and stored for thirty days. Catheters coated with such solutions exhibited antimicrobial properties, i.e., they produced a zone of inhibition when placed in a growth medium and challenged with microorganism, for thirty days after being coated.
There have been efforts to prepare antibacterial surgical devices such as sutures as disclosed in U.S. Pat. No. 6,514,517 B2 (Antibacterial Coatings for Medical Devices); U.S. Pat. No. 6,881,766 B2 (Sutures and Coatings Made from Therapeutic Absorbable Glass) and WO 2004/032704 A2 (Packaged Antimicrobial Medical Device and Method of Preparing Same).
There have been several closure devices disclosed in prior art as described in U.S. Pat. No. 6,090,130 (Hemostatic puncture closure system including blood vessel locator and method of use) and U.S. Pat. No. 6,179,863 B1 (Hemostatic puncture closure system and method of use) by Kensey Nash Corporation; US 2007/0073345 A1 (Vascular sealing device with high surface area sealing plug), US 2007/0032824 A1 (Tissue puncture closure device with track plug), US 2007/0032823 A1 (Tissue puncture closure device with coiled automatic tamping system), US 2006/0265007 A1 (Tissue puncture closure system with retractable sheath), US 2006/0058844 A1 (Vascular sealing device with locking system) and US 2005/0267521 A1 (Collagen sponge for arterial sealing) by St. Jude Medical; and U.S. Pat. No. 6,969,397 (Guide wire element for positioning vascular closure devices and method for use) and US 2005/0267528 A1 (Vascular plug having composite construction) by Ensure Medical. In these disclosures, bioabsorbable plugs were used for puncture closure.
Most implantable medical devices are manufactured, sterilized and contained in packages until opened for use in a surgical procedure. During surgery, the opened package containing the medical device, packaging components contained therein, and the medical device, is exposed to the operating room atmosphere, where bacteria from the air may be introduced. Incorporating antimicrobial properties into the closure plug delivery system, package and/or the packaging components contained therein substantially prevents bacterial colonization on the package and components once the package has been opened. The antimicrobial package and/or packaging components in combination with the incorporation of antimicrobial properties onto or into the medical device itself would substantially ensure an antimicrobial environment about the sterilized medical device.